Ghrelin: a new peptide regulating the neurohormonal system and energy homeostasis. Research leading to the identification of ghrelin started with the discovery of growth hormone secretagogues, continued with the description of ghrelin receptors and ended with description of the chemical structure of ghrelin. However, several aspects concerning the role of ghrelin in physiology and pathophysiology are still under investigation. The majority of ghrelin is produced in the stomach, but it is also expressed in the hypothalamus, pituitary, intestine, kidney, heart, pancreas and gonads. Ghrelin stimulates growth hormone secretion via growth hormone secretagogue receptors, and it increases appetite. Ghrelin secretion in the stomach depends on both acute and chronic changes in energy balance. Presently available data support the hypothesis that the stomach, in addition to its important role in digestion, not only influences pituitary hormone secretion via ghrelin production but it also sends orexigenic (appetite increasing) signals to hypothalamic nuclei involved in the regulation of energy homeostasis. In addition to these main effects, ghrelin influences the cardiovascular, gastrointestinal, reproductive and endocrine functions. It can be anticipated that further research on the physiological and pathophysiological role of ghrelin will lead to a better understanding of neurohormonal processes and the central regulation of energy homeostasis.